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54 Cards in this Set

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  • Back
What are the expected levels of TSH & thyroid hormone in primary hyperthyroidism?
high thyroid hormone w/low TSH
How do you assess pitiutary function?
give a sugar loading test; sugar should decrease cortisol levels if it's healthy
Where are the components of the adrenal glands derived from?
medulla=neural crest
What controls the zona fasciculata?
renin-angiotensin system
What does the zona fasciculata secrete?
What controls the zona fasciculata?
ACTH, CRH (hypothalamus)
What does the zona fasciculta secrete?
cortisol, sex hormones
What controls the zona reticularis?
ACH, CRH (hypothalamus)
What does the zona reticularis secrete?
sex hormones
What controls the medulla?
preganglionic sympathetic fibers
What does the medulla secrete?
catecholamines (Epi, NE)
What is a pheochromocytoma?
medullary adrenal tumor that causes episodic hypertension
Do the R/L adrenal glands differ in how they drain?
yes; L= L adrenal vein-> L renal vein*-> IVC (R gland doesn't have R renal vein)
What is a neurohypophysis?
the posterior pituitary
What is an adenohypophysis?
the anterior pituitary
What does the posterior pitiutary secrete?
vassopressin & oxytocin (NOTE: these are MADE in the hypothalamus but SECRETED by the posterior pituitary)
What does the anterior pituitary secrete?
FSH, LH, ACTH,TSH, prolactin, GH
think "FLAT PiG"
What is an alpha subunit?
common piece to TSH, LH, FSH, & hCG
What is the beta subunit?
determines hormone specificity
What does prolactin do?
it increases dopamine synthesis/secretion from the hypothalmus (increased dopamine-> prolactin inhibition); thus a dopamine agonist are used to tx hyperprolactemia; it inhibits GnRH in females
What increases prolactin production?
What increases TSH production?
What increases ACTH production?
What increases FSH & LH production?
What increases GH production?
What does somatostatin inhibit?
How is aldosterone synthesized?
ACTH + cholesterol (via desmolase or circulating)+ 33-hydroxysteriod dehydrogenase
->progesterone-> 11-deoxycorticosterone -> corticosterone + aldosterone synthase ->aldosterone
How is cortisol synthesized?
17-hydroxypregnenolone (from pregnenolone) -> 17 alpha-hydroxyprogesterone (from progesterone) -> 11-deoxycortisol (from 11-deoxycorticosterone) -> cortisol
How is DHEA synthesized?
from 17-hydroxypregnenolone
How is testosterone synthesized?
DHEA -> androstendione (from 17 alpha-hydroxyprogesterone) -> testosterone (reduced to DHT)
how is estrone synthesized?
from androstenedione
how is estradiol synthesized?
from testosterone
what happens w/a 17 alpha-hydroxylase deficiency?
low sex hormones, low cortisol, high mineralocorticoids; hypertension, hypokalemia, phenotypically female w/o maturation
what happens w/a 21 beta-hydroxylase deficiency?
low cortisol, low mineralocorticoids, high sex hormones, high ACTH; hypotension, hyponatremia, hyperkalemia, volume depletion, masculinization of females
what happens w/11 beta-hydroxylase deficiency?
low cortisol, low aldosterone, increased sex hormones, hypertension, masculinization of females
What makes parathyriod hormone?
chief cells of the parathyroids.
What does parathyroid hormone do?
increases bone resorption of Ca & P, increases kidney reabsorption of Ca, decreases kidney reabsorption of P, increases vitamin D production.
What motivates parathyroid hormone?
decreased serum Ca.
What's the significance of increasing vitamin D production?
vitamin D increases absorption of Ca & P by the intestines & increases bone resorption of Ca & P.
What is the active form of vitamin D?
vitamins D3 & D2 are turned into 25-OH by the liver & then to the active form of 1,25-(OH)2 by the kidney.
How does hyperparathyroidism affect Ca, P, & alk phos levels?
elevates Ca, lowers P, & elevates alk phos.
How does Paget's disease affect alk phos?
majorly increases it.
How does renal insufficiency affect Ca & P?
decreases Ca, elevates P.
Where does calcitonin come from?
parafollicular cells of the thyroid (C-cells).
What does calcitonin do?
it decreases bone resorption of(opposes PTH). BOTH PTH & calcitonin are stimulated by increase in serum Ca.
Name the steroid/thyroid hormones.
think "PET CAT"; progesterone, estrogen, testosterone, cortisol, aldosterone, thyroxine & T3
Where do thyroid hormones come from?
T4 & some T3 come from follicles (most of T3 is formed in the blood).
What does T3 do?
brain maturation, bone growth, beta-adrenergic effects, increase BMR. think "4 B's"
What regulates thyroid hormone secretion?
TRH (hypothalamus) -> TSH (ant pituitary) -> follicular cells -> T4/T3
What happens to thyroid binding protein during pregnancy?
increased production -> decrease free hormone; estrogen increases TBG
Which tissues are dependent on insulin for glucose absorption?
skeletal mm & adipose tissue.
Where does cortisol come from?
adrenal gland; zona fasciculata.
What does cortisol do?
anti-inflammatory, increases metabolism, suppresses immune fx & bone formation.
How is cortisol regulated?
CRH (hypothalamus)-> ATCH (ant pituitary) -> adrenal fasiculata -> cortisol.